Objective: The primary objective of this research is to explore the levels of serum glycosylated hemoglobin (HbA1c) and urinary microalbumin (mALB) in relation to their clinical relevance among individuals diagnosed with gestational diabetic retinopathy (DR). Methods: A total of 80 pregnant women diagnosed with gestational diabetes (GDM group), The DR group consisted of 75 pregnant women who were diagnosed with diabetic retinopathy during the course of their pregnancies(DR group), and 95 women with uncomplicated pregnancies (normal control group) were recruited for this study between January 2019 and January 2021.Serum HbA1c levels were measured utilizing a glycosylated hemoglobin analysis system, whereas urine mALB, low-density lipoprotein cholesterol (LDL-C), triacylglycerol (TG), and total cholesterol (TC) levels were assessed through an automated biochemical analysis instrument.The fasting blood glucose (FPG) and 2-hour postprandial blood glucose (2hPG) were determined by employing a blood glucose monitoring device to measure the levels of glucose in the bloodstream. Results: Compared to the control group, patients in the GDM and DR cohorts exhibited a marked elevation in FPG, 2hPG, TG, LDL-C, serum HbA1c, TC and urine mALB levels, indicating statistically significant differences (P<0.05).In comparison to the GDM group, the levels of these parameters were notably elevated in the DR group, with statistically significant differences observed (P<0.05). Moreover, there was a significant correlation between the severity of DR and the increased levels of HbA1c and mALB (P<0.05).The poor prognosis group exhibited significantly elevated levels of FPG, 2hPG, TG, LDL-C, serum HbA1c, TC, and urine mALB compared to the good prognosis group (P<0.05).The multivariate logistic regression analysis revealed that increased levels of serum HbA1c and urinary mALB were identified as risk factors associated with a poor prognosis among patients diagnosed with DR. Moreover, the analysis of the receiver operating characteristic (ROC) curve demonstrated that the area under the curve (AUC) values for serum HbA1c, urine mALB, and their combined diagnostic approach regarding the prediction of a poor prognosis among DR patients were 0.748 (95% CI: 0.624-0.873), 0.803 (95% CI: 0.689-0.917), and 0.874 (95% CI: 0.792-0.957), respectively. Conclusion: The findings suggest that DR patients have elevated levels of serum HbA1c and urine mALB, which may be useful for the diagnosis and assessment of DR prognosis.